Upper back pain can feel like an ache between your shoulder blades, stiffness after sitting for hours, or a sharper pain with certain movements. It may develop after lifting, repetitive activity, or spending too much time in one position.
In many cases, the muscles, joints, posture, or movement habits play a role. However, upper back pain can have different causes, so it is important to look at how and when your symptoms occur.
At DeCarlo Chiropractic in New City, NY, we evaluate spinal movement, posture, and other factors that may contribute to ongoing discomfort.
What is upper back pain?
Upper back pain occurs between the base of your neck and the bottom of your rib cage. This area contains the thoracic spine, which includes 12 vertebrae and connects with your ribs.
Pain may occur along the spine, between the shoulder blades, or in the surrounding muscles.
Upper back pain may feel like:
- A dull or aching pain
- Tightness or stiffness
- Burning discomfort
- Sharp pain with certain movements
- Tenderness around the shoulder blades
- Reduced upper back movement
- Discomfort after sitting for a long time
Where the pain occurs and what makes it better or worse can provide useful clues about the cause.
Pain that begins higher in the cervical spine may behave differently. Persistent neck pain can also spread toward the shoulders or upper back.
What causes upper back pain?
There is no single cause. Some cases begin after a specific activity or injury, while others develop gradually.
Muscle strain and overuse
Upper back muscles can become sore after lifting, exercise, repetitive work, or a sudden increase in activity.
Repeating the same movement throughout the day can also lead to muscle fatigue and discomfort. You may notice soreness, tenderness, or pain that changes when you move.
Prolonged sitting and posture
Hours at a desk can leave the upper back stiff or tired, especially when you rarely change position.
Your head, shoulders, spine, and surrounding muscles work together to support your body. Staying in one position for a long time can make some muscles work continuously while other areas move very little.
Rounded shoulders or a forward head position may contribute to discomfort in some people. Recognizing the signs of poor posture can help identify habits that may be adding stress to the upper back.
Joint and spinal problems
Upper back pain can also involve the joints and structures of the thoracic spine.
Possible factors include joint irritation, age related changes, scoliosis, increased spinal curvature, injury, and disc problems.
These findings do not always cause pain. Symptoms, movement, medical history, and examination findings should be considered together rather than assuming an imaging finding explains the problem.
Pain coming from another area
Not all upper back pain starts in the muscles or spine. Sometimes pain is referred to from another part of the body.
Upper back pain that occurs with chest pain, difficulty breathing, dizziness, sweating, or other unusual symptoms should not automatically be treated as a back problem. These symptoms may require prompt medical evaluation.
How are posture and upper back pain connected?
Posture can contribute to upper back discomfort, but there is no single perfect position that prevents pain.
The bigger problem may be spending too much time in one position. Long periods at a computer can reduce movement through the upper spine while the muscles around the shoulders and neck continue supporting your head and arms.
Over time, this may contribute to stiffness or fatigue between the shoulder blades.
Instead of trying to sit perfectly all day, change positions regularly, move throughout the day, and arrange your workspace so you can work comfortably.
What can help relieve upper back pain?
The right approach depends on the cause and severity of your symptoms. For mild musculoskeletal discomfort, a few changes may help:
- Keep moving comfortably. Continue normal movement as tolerated instead of remaining inactive for long periods.
- Change positions regularly. Avoid sitting or standing in exactly the same position for hours.
- Take movement breaks. Short walks or gentle shoulder and upper back movements can break up long periods of sitting.
- Try heat or cold. Either may temporarily ease muscle soreness for some people.
- Review your workstation. Adjust your chair, screen, and keyboard to reduce unnecessary reaching or strain.
- Modify aggravating activities. Temporarily reduce activities that clearly make the pain worse.
Stop an exercise or movement if it causes sharp pain, significant numbness, weakness, or worsening symptoms.
When can a chiropractor help with upper back pain?
Chiropractic care may be appropriate when upper back pain appears to involve musculoskeletal factors such as spinal joints, movement, muscles, or posture.
An evaluation can look at where the pain occurs, which movements affect it, your posture, previous injuries, and whether neurological symptoms are present.
At DeCarlo Chiropractic, we focus on corrective chiropractic and posture rather than looking only at the painful area. Depending on your symptoms and examination findings, assessment may include a physical and neurological examination, postural analysis, and digital X-rays when clinically appropriate.
The purpose is to identify factors that may be contributing to the problem and determine whether chiropractic care is appropriate for your situation.
When should upper back pain be medically evaluated?
Upper back pain should be evaluated when it keeps returning, does not improve, or begins interfering with normal activities.
Seek medical evaluation if:
- Pain follows a significant injury.
- Symptoms are severe or getting worse.
- You develop unexplained fever or weight loss.
- You experience persistent numbness or weakness.
- Pain continues despite reasonable self care.
Seek immediate medical attention if upper back pain occurs with chest pain, difficulty breathing, sudden significant weakness, or loss of bladder or bowel control.
These warning signs are important because not every upper back symptom comes from the muscles, posture, or spine.
Getting upper back pain properly evaluated
Upper back pain may come from muscle strain, prolonged sitting, repetitive movement, posture, or problems involving the spine and surrounding joints. The right next step depends on the cause and your symptom pattern.
When pain keeps returning or does not improve, an evaluation can help identify factors that may be contributing to it.
At DeCarlo Chiropractic in New City, we assess spinal movement and posture to determine whether corrective chiropractic care may be appropriate. If upper back pain is affecting your daily activities or continues to return, contact us to discuss your symptoms.
Frequently asked questions about upper back pain
Where is upper back pain usually felt?
Upper back pain occurs between the base of the neck and the bottom of the rib cage. It is often felt along the thoracic spine or between the shoulder blades.
Why does my upper back hurt between my shoulder blades?
Muscle strain, repetitive activity, prolonged sitting, and irritation of surrounding joints or tissues can cause pain between the shoulder blades. Persistent pain may need further evaluation.
Can poor posture cause upper back pain?
Posture can contribute to upper back discomfort, especially when you stay in the same position for long periods. Regular movement and changing positions are also important.
How long does upper back pain usually last?
It depends on the cause. Mild muscle related discomfort may improve with time and activity changes. Pain that persists, returns frequently, or gets worse should be evaluated.
Can a chiropractor help with upper back pain?
Chiropractic care may help some musculoskeletal causes of upper back pain involving spinal movement, joints, muscles, or posture. An evaluation is needed to determine whether it is appropriate.
When should I worry about upper back pain?
Seek prompt medical care for severe or rapidly worsening pain, significant trauma, numbness, or weakness. Upper back pain with chest pain, difficulty breathing, or loss of bladder or bowel control requires urgent medical attention.